Provider Demographics
NPI:1851596589
Name:GROVE CITY ENDODONTICS, INC
Entity Type:Organization
Organization Name:GROVE CITY ENDODONTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ERVIN
Authorized Official - Last Name:CLAFFEY
Authorized Official - Suffix:IV
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:614-277-9455
Mailing Address - Street 1:4203 GANTZ RD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-2993
Mailing Address - Country:US
Mailing Address - Phone:614-277-9455
Mailing Address - Fax:614-277-9133
Practice Address - Street 1:4203 GANTZ RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-2993
Practice Address - Country:US
Practice Address - Phone:614-277-9455
Practice Address - Fax:614-277-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty